Induction Treatment With Cyclophosphamide, Thalidomide, and Dexamethasone in Newly Diagnosed Multiple Myeloma: A Phase II Study

• DOI: 10.3816/clml.2010.n.007
• Publication Date: 2010-02-09T02:01:27Z
• Authors: Deok-Hwan Yang; Yeo-Kyeoung Kim; Sang-Kyun Sohn; Joo-Seop Chung; Young-Don Joo; Jae-Hoon Lee; Jung-Lim Lee; Jae-Sook Ahn; Joon-Ho Moon; Ho-Jin Shin; Young-Jin Choi; Won-Sik Lee; Hyeoung-Joon Kim; Je-Jung Lee
• Keywords: Adult; Male; Hematopoietic Stem Cell Transplantation; Middle Aged; Dexamethasone; Thalidomide; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Antineoplastic Combined Chemotherapy Protocols; Humans; Female; Multiple Myeloma; Cyclophosphamide; Aged

Thalidomide has alternative mechanisms of action; it can be combined with dexamethasone or alkylating agents for the treatment of multiple myeloma (MM); however, the optimal doses and appropriate intervals of thalidomide continue to be debated.We assessed the clinical efficacy and toxicity of thalidomide in patients with newly diagnosed MM; 68 patients were treated with pulsed cyclophosphamide, thalidomide, and dexamethasone (CTD) chemotherapy for induction treatment.After a median of 28 months' follow-up, the overall response rate was 79.4%, with a 42.6% complete response (CR) or very good partial response (VGPR). Patients with cytogenetically high-risk disease had poor CR/VGPR rates (27.3%) at a median of 11.5 months of time to progression (TTP) compared with patients with standard-risk disease who achieved CR/VGPR rates (50%) at a median of 20.3 months of TTP. The major adverse events included peripheral sensory neuropathy (14.3%), infection (10.2%), and thromboembolic complications (5.9%). Thirty-two patients who achieved more than a PR proceeded to peripheral blood stem cell collection with a median number of 5.0 x 106 CD34+ cells/kg collected.CTD resulted in a favorable response with tolerable toxicity in patients with MM and did not affect the yield of the stem cell collection.